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Declaration ot Dor~niCile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, •
Sl. lUC1E COUNTY, FIORIDA:
This ~s my declaration of Domicile and Citizenship in the State of Florida that 1 am filing ihis day in accordance and
~n conformity with Chapter 222, Section 222.17, Ftorida Statutes.
( Harrisburg )
Yt. Rt. Enola - -
I was forme~ly a legal resident of _ _ _
iCity) (State)
and I resided at _ _ _ _ _ . _ , _ _ _ _ However I have changed my domiG~e
(St~eet and Number)
to and am and have been a bona fide resideM of the State of Florida since _ 5th day of
- - - - - Atigl,la~ _ _ _ 19-- and 1 reside at - 47~5 El¦ A~e . Whi~S _ _(~`1.t~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUN?Y, FLORtDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
2218l~2
Establiahing residence
FILED 4NQ RECOROED
ST. WCIf COUMTY FLA.
- ROGE~ POITRAS
CIEkK C?~'CU1T COURT
RECQRO Vfr~~iEO~~
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~ I FURTHER CERTIFY that ! will comply with al) other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that 1 have no intention to return to my former domi~ile, and 1 intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FlORIOA, permanentl o
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(Name)
~ Robert J. Cressler „
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- • : ( )
_ . ;w
f~ • - Bertha I. Creasler
2.~ `sOb~ctibed before me this _ llth day of January ~ ~q~2
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~~R,RO.lYIZ!?S ~
:41RCU~T COURT Notary Public
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- By a-~~~ D.C. My Commission expires ;
:
;s`::s
- (To b~ execuMd in dupliut~ and ori~insl ~i{ad with Cl~rlc Grcuit Cour~, and duplicat~ with Tax Ass~s~or.)
BOOK 198 Fa~~ 2064
tio. 13
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